Retinopathy of prematurity

PURPOSE
To measure macular choroidal thickness (CT) in highly myopic eyes using enhanced depth imaging optical coherence tomography (OCT).


DESIGN
Retrospective, observational case series.


METHODS
Enhanced depth imaging OCT images were obtained in highly myopic eyes (> or =6 diopters [D]). Images of CT were obtained by positioning a spectral-domain OCT device close enough to the eye to acquire an inverted image. CT was measured from the outer border of the retinal pigment epithelium to the inner scleral border at 1000-mum intervals of a horizontal section from 3 mm temporal to the fovea to 3 mm nasal to the fovea. Statistical analysis was performed to evaluate CT at each location and to correlate CT with age and refractive error.


RESULTS
The mean age of the 31 patients (55 eyes) was 59.7 years (+/- 17.6 years; range, 24 to 90 years), and the mean refractive error was -11.9 D (+/- 3.7 D). The mean subfoveal CT was 93.2 microm (+/- 62.5 microm) and was correlated negatively with age (P = .006), refractive error (P < .001), and history of choroidal neovascularization (P = .013). Regression analysis suggested that subfoveal CT decreased by 12.7 mum for each decade of life and by 8.7 microm for each D of myopia.


CONCLUSIONS
The choroid in highly myopic eyes is very thin and undergoes further thinning with increasing age and degree of myopia. Abnormalities of the choroid may play a role in the pathogenesis of myopic degeneration.

Enhanced Depth Imaging Optical Coherence Tomography of Choroid in Highly Myopic Eyes

Spectral-Domain OCT Measurements in Alzheimer's Disease: A Systematic Review and Meta-analysis.

Background/Aims To identify the retinal vascular pathologies in patients with Alzheimer’s type dementia (ATD) through optical coherence tomography angiography (OCTA) imaging. Methods Our study included 26 patients in the patient group, and age-matched and sex-matched 26 subjects in the control group. A detailed ophthalmological and neurological examination was performed for all subjects included in the study. The retinal, choroidal vascular structures and choroidal thickness (CT) of all subjects were analysed in a detailed way with a commercial spectral domain OCTA. Moreover, all participants underwent detailed neurological examination including Mini Mental State Examination (MMSE) test to evaluate cognitive function. Results In the group of patients with ATD, the MMSE score was significantly lower than that of the control group (p 0.05). Furthermore, significant correlation was found between the MMSE and all vascular density parameters, CT parameter and FAZ tested with OCTA imaging (p Conclusions In patients with ATD, retinal and choroidal vascular pathologies detected through OCTA imaging can be used as a new biomarker in the early diagnosis of the disease, follow-up of its progression and in investigating the efficacy of the drugs.

https://bjo.bmj.com/content/bjophthalmol/102/2/233.full.pdf

Evaluation of optical coherence tomography angiographic findings in Alzheimer's type dementia.

Retinopathy of prematurity (ROP) is an important cause of childhood blindness globally, and the incidence is rising. The disease is characterized by initial arrested retinal vascularization followed by neovascularization and ensuing retinal detachment causing permanent visual loss. Although neovascularization can be effectively treated via retinal laser ablation, it is unknown which children are at risk of entering this vision-threatening phase of the disease. Laser ablation may itself induce visual field deficits, and there is therefore a need to identify targets for novel and less destructive treatments of ROP. Inflammation is considered a key contributor to the pathogenesis of ROP. A large proportion of preterm infants with ROP will have residual visual loss linked to loss of photoreceptor (PR) and the integrity of the retinal pigment epithelium (RPE) in the macular region. Recent studies using animal models of ROP suggest that choroidal degeneration may be associated with a loss of integrity of the outer retina, a phenomenon so far largely undescribed in ROP pathogenesis. In this review, we highlight inflammatory and neuron-derived factors related to ROP progression, as well, potential targets for new treatment strategies. We also introduce choroidal degeneration as a significant cause of residual visual loss following ROP. We propose that ROP should no longer be considered an inner retinal vasculopathy only, but also a disease of choroidal degeneration affecting both retinal pigment epithelium and photoreceptor integrity.

https://link.springer.com/content/pdf/10.1186/s12974-017-0943-1.pdf

Retinopathy of prematurity: inflammation, choroidal degeneration, and novel promising therapeutic strategies.

PURPOSE To evaluate choroidal thickness in premature infants and its relationship with stage of retinopathy of prematurity (ROP) using spectral domain optical coherence tomography (SD-OCT). METHODS Spectral domain optical coherence tomography imaging for measuring subfoveal choroidal thickness was performed for 80 premature infants. Subfoveal choroidal thickness was defined as the distance from the hyperreflective line of the outermost retinal pigment epithelium (RPE) to the innermost hyperreflective line of the choroidoscleral junction. Each measurement was performed at the central fovea (CF) and 0.75 mm to 1.5 mm nasal (N1 and N2) and temporal (T1 and T2) to the fovea. Subfoveal choroidal thickness and grading of cystoid macular edema (CME) were analyzed statistically. RESULTS Choroidal thickness of CF was found to be significantly greater than nasal (N1 and N2) and temporal (T1 and T2) choroidal thickness (P 0.05). The choroidal thickness of CF was found to be correlated with birth weight (r = 0.267, P = 0.017) but not birth week (r = 0.140, P = 0.217). Maximum stage of ROP was found to be negatively correlated with choroidal thickness, at N1, T1, and T2 (r < -0.250, P < 0.02). CONCLUSION The subfoveal choroid in premature infants can be effectively evaluated using a portable SD-OCT device. Choroidal thickness gets thinner with the severity of ROP and the decrease is more prominent at the central and temporal location. Cystoid macular edema is not correlated with choroidal thickness in premature infants.

Choroidal thickness in infants with retinopathy of prematurity.

OBJECTIVE To assess the effect of morbid obesity on retinal nerve fiber layer (RNFL) thickness, central macular thickness (CMT), retinal ganglion cell (RGC), choroidal thickness (CT), central corneal thickness (CCT), and intraocular pressure (IOP). PATIENTS AND METHODS Sixty-seven patients defined as having morbid or class III obesity (BMI ≥ 40; Group 1) scheduled to undergo sleeve gastrectomy surgery and 29 nonobese patients (BMI 18.50-24.99; Group 2) underwent complete ophthalmic examination for measurement of IOP, CT, RNFL thickness, CMT, RGC, and CCT. RNFL thickness, CMT, and RGC were measured using spectral-domain optical coherence tomography (SD-OCT). CT measurement was performed using the enhanced depth imaging technique of the SD-OCT. The group data were analyzed and compared using the Mann-Whitney U test and Student's t-test. The relationship between the clinical ocular variables and obesity was analyzed using the Spearman's rank correlation test. RESULTS The mean IOP and CCT of Group 1 were found to be significantly higher (p < 0.001) and the mean RNFL, RGC, and CT significantly lower (p < 0.05) than those of Group 2. While Group 2 was found to have a slightly larger cup-to-disc ratio and Group 1 to have a thinner CMT, the differences between Groups 1 and 2 regarding these variables were not found to be statistically significant (p = 0.322 and p = 0.072, respectively). The results of Spearmen correlation analysis indicated the existence of a moderately positive correlation between IOP and BMI (p < 0.001; r = 0.5-0.6). CONCLUSIONS We have demonstrated by SD-OCT that morbid obesity may have a significant influence on RNFL, RGC, and CT. Morbid obesity may induce inflammatory, hormonal, and metabolic changes.

The retinal nerve fiber layer, choroidal thickness, and central macular thickness in morbid obesity: an evaluation using spectral-domain optical coherence tomography.

Purpose. To examine the macular findings obtained with spectral domain optical coherence tomography (SD OCT) in infants with retinopathy of prematurity (ROP). Materials and Methods. The macular SD OCT images of 190 premature infants were analyzed. Data regarding central foveal thickness (CFT), cystoid macular edema (CME), and cyst grading were compared. The relationships of CFT with gestational age and birth weight were investigated. Results. The results were obtained from 358 eyes of 179 infants (81 females and 98 males) of a mean gestational age of weeks and a mean birth weight of &#x2009;g. ROP was diagnosed in 126 eyes and CME in 139 eyes. A significantly greater percentage of eyes with ROP were found to have CME (54&#x25;) compared to eyes without ROP (31&#x25;; ). The incidence of CME was 46.3&#x25; for stage 1 ROP, 57.1&#x25; for stage 2, and 87.5&#x25; for stage 3. There was a weakly inverse correlation between CFT, gestational age, and birth weight (, ; , , resp., Spearman correlation test). Conclusions. High-quality SD OCT images can be obtained from premature infants using the iVue system. Severity and frequency of CME in premature infants increase as stage of ROP increases.

/pdf/macular-findings-obtained-by-spectral-domain-optical-5ce26vd2tj.pdf

Macular findings obtained by spectral domain optical coherence tomography in retinopathy of prematurity

Purpose Juvenile myoclonic epilepsy (JME) is commonly associated with photoparoxysmal response (PPR) with a reported prevalence of 25–42%. In this study, we aim to explore the relationship between the PPR and Optical Coherence Tomography (OCT) parameters in order to determine whether optic nerve fiber layer or other structural differences have a pathophysiological role of photosensitivity in patients with JME. Methods We studied 53 consecutive patients with Juvenile myoclonic epilepsy (JME) at our outpatient department. The interictal electroencephalogram (EEG) findings for each patient were analyzed for the presence of photoparoxysmal features. The peripapillary Retina Nerve Fiber Layer (RNFL) thickness, ganglion cell thickness, macular thickness and choroid thickness levels were analyzed using OCT. Results We classified the patients into two groups as those with PPR (Group 1) and those without PPR (Group 2). There were statistically significant differences in the average RNFL thickness values of the left eye between the two groups ( p p p p Conclusion This is the first study to our knowledge which has investigated the relation between the OCT parameters and photosensitivity in patients with JME. We concluded that these microstructural features may be related to photosensitivity in patients with JME.

Optical coherence tomography parameters in patients with photosensitive juvenile myoclonic epilepsy

Purpose. To investigate changes in optical coherence tomography parameters in morbidly obese patients who had undergone laparoscopic sleeve gastrectomy (LSG). Methods. A total of 41 eyes of 41 morbidly obese patients (BMI ≥ 40) who had undergone LSG were included in study. The topographic optic disc parameters, central macular thickness (CMT), total macular volume (TMV), and retinal ganglion cell layer (RGCL) were measured by spectral-domain optical coherence tomography (SD-OCT). Subfoveal choroidal thickness (SFCT) was measured by enhanced deep imaging-optical coherence tomography (EDI-OCT). Results. The mean CMT was 237.4 ± 24.5 μm, 239.3 ± 24.1 μm, and 240.4 ± 24.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). The mean TMV was 9.88 ± 0.52 mm(3), 9.96 ± 0.56 mm(3), and 9.99 ± 0.56 mm(3) preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). The mean RGCL was 81.2 ± 6.5 μm, 82.7 ± 6.6 μm, and 82.9 ± 6.5 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). The mean SFCT was 309.8 ± 71.8 μm, 331.0 ± 81.4 μm, and 352.7 ± 81.4 μm preoperatively, 3 months postoperatively, and 6 months postoperatively, respectively (p < 0.01). No statistically significant differences were found between the preoperative values and 3- and 6-month postoperative values in rim area (p = 0.34), disc area (p = 0.64), vertical cup/disc ratio (p = 0.39), cup volume (p = 0.08), or retinal nerve fiber layer (p = 0.90). Conclusions. Morbidly obese patients who undergo LSG experience a statistically significant increase in CMT, TMV, SFCT, and RGCL at 3 months and 6 months after surgery.

/pdf/optical-coherence-tomography-parameters-in-morbidly-obese-3c818o5cb8.pdf

Optical Coherence Tomography Parameters in Morbidly Obese Patients Who Underwent Laparoscopic Sleeve Gastrectomy

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